CalAim 14 Community Supports by Managed Care Provider by County:
https://www.dhcs.ca.gov/Documents/MCQMD/Community-Supports-Elections-by-MCP-and-County.pdf
Under CalAIM there will be several new Medi-Cal programs to improve care for populations with complex health needs, including:
- Enhanced Case Management:
Individuals will receive assistance enrolling in Medi-Cal if they are not already. They will also receive intensive and frequent outreach. The priority will be on in-person interactions or using other methods to reach people who need the extra assistance. This can include phone, text and email as well as in-person, and translation for non-English speakers.
The Medi-Cal workers in CalAIM will develop a plan of care for the member and their family and other supportive persons. The care plan is based on the needs and desires of the person and will be reviewed often and modified as needed. The care plan incorporates the person’s needs in the areas of physical health, mental health, social supports and other needs including also food and housing. The workers can for example make referrals to shelters or to permanent housing and help the person get all the information necessary to qualify for services. The worker will maintain contact with the member on a regular and frequent basis and revise the plan as necessary together with the person’s support group including family members and others.
- Community Support or “In Lieu of Services”: Your plan may include the following community supports:
Housing supports:
- Assistance applying for and finding housing; signing a lease, securing resources for utilities; move in costs;
- Housing deposits;
- Dispute resolution with landlords and neighbors
Short-term recovery supports:
- Short-term, post-hospitalization housing
- Recuperative care [medical respite]
- Respite care for caregivers
Independent living support:
- Training on independent living skills [cooking, cleaning and shopping]
- Nursing facility transition
- Community transition services
- Personal care
- Medically tailored meals
- Asthma remediation
- Prerelease/in-reach care for people who are incarcerated: CA is currently seeking a federal waiver to expand Medi-Cal coverage to include:
- 90 days prior to release from jail or prison, services for people who are incarcerated include case management/care coordination; physical and behavioral health consultation; medication-assisted treatment for addiction;
- Following release, a 30-day supply of medication and any needed medical equipment such as a walker.
- Health Management: Managed care plans are encouraged to develop a comprehensive health management plan, for example, recipients of CalAIM services will be encouraged to choose healthy behavior and to learn to monitor their own health successfully, for example, to quit smoking and to manage other conditions .